State of Missouri Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102 John R. Ashcroft, Secretary of State Registration Number of fictitious name, filed with our office, to be cancelled: X Name of fictitious name, filed with our office, to be cancelled: Cancellation of Registration of Fictitious Name (No Fee Required) Business address of above listed fictitious name registration at time of filing to be cancelled In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.060 RSMo) Authorized Signature Authorized Signature Authorized Signature Printed Name Printed Name Printed Name Date Date Date Signature of at least one owner as listed on fictitious name to be cancelled Name and address to return filed document: Name: Address: City, State, and Zip Code: Corp. 14 (01/2017) American LegalNet, Inc. www.FormsWorkFlow.com

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